Pelvic Floor Evaluation

Patients suffering from conditions related to pelvic floor dysfunction may be evaluated with one or several of the following diagnostic tests; the results will help your surgeon recommend the most appropriate medical or surgical treatment.In most cases, your surgeon will discuss your results immediately following the conclusion of the tests. However, if there are other test results pending, such as completion of a Defocography or Dynamic Pelvic Floor MRI, your surgeon will need to compile the data together before being able to reach a conclusion and make recommendations for treatment. In these cases, patients will be asked to return for another office visit after all the tests are completed.

Anal Manometry Testing

Anal Manometry Testing is an evaluation of the strength of the muscles which control bowel movements. The test is performed by placing a small tube (about the size of a drinking straw) into the rectum. Rectal sensation will be obtained and pressure monitors inside the tube will measure the muscle strength; the results will be recorded by a computer graph similar to an electrocardiogram (EKG). This test is painless and takes about 10 minutes to perform. Preparation Instructions


Defocography is an x-ray test of the function of the rectum and pelvic floor muscles; these muscles control the rectum and anus during evacuation and are responsible for the control of bowel movements. This painless 15 minute test is done at INOVA Fairfax Hospital and administered by one of their Radiologists. At the time the test is ordered, our office will provide the patient a CD-Rom to take with them to the test. Upon arrival, the patient will be asked to drink a small amount of barium; a small amount of barium paste is placed into the rectum and if applicable, vagina. A recording of the x-ray is made on the CD during evacuation of the paste. The CD recording will need to be dropped off at our Fairfax Prosperity Avenue Office so that their surgeon can review the x-ray recording prior to your next appointment.

Dynamic Pelvic Floor MRI

Dynamic Pelvic Floor Magnetic Resonance Imaging is a test used to further evaluate pelvic floor function. The MRI scan can detect changes in the pelvic floor musculature, as well as changes in the position of the small intestine, bladder, uterus, and rectum, which may be responsible for some of the problems with defecation or fecal incontinence. Although no x-rays are used, the test is similar to a CT scan. The test is painless and takes about 15 minutes. No preparation of the bowel is required for the test. A small amount of contrast will be inserted into the rectum at the time of the test. This test is performed at the Fairfax MRI Center located at 8318 Arlington Blvd in Fairfax, VA.

Electromyography (EMG)

Electromyography (EMG) tests the electrical activity of the pelvic floor muscles when the patient squeezes them or pushes to defecate. It is performed by placing two small, sticky electrodes on the skin surface just outside the anal opening. The patient is asked to squeeze the sphincter muscles and then push as if they were having a bowel movement. The degree to which the muscles generates an electric impulse is measured by the computer. This test takes only a few minutes to perform and the patient will not experience pain or feel any electrical current from the electrodes. Preparation Instructions

Pudendal Nerve Testing

Pudendal Nerve Testing is commonly performed to evaluate problems with fecal incontinence: The pudendal nerve is the nerve that innervates the anal sphincter muscle and must work correctly for the muscle to squeeze appropriately. It is performed using a small sensor placed on the tip of a gloved finger and is inserted into the rectum, similar to having a rectal exam. A tiny amount of electrical stimulation is given through the electrode at the tip. This test is painless and takes about 10 minutes to perform; although the patient does not feel any electric shock, they may feel the sphincter muscle twitch slightly. Preparation Instructions